A longitudinal analysis of 7,219 US adults aged 50 and older found that subjective financial strain increased incident heart disease risk by 18% over 16 years of follow-up, even after controlling for actual income and wealth. Among the 1,423 participants (19.7%) reporting high financial strain, cardiovascular events occurred at significantly higher rates compared to those with low or no perceived financial stress. The psychological burden of financial worry appears to operate through pathways beyond mere economic disadvantage, potentially involving chronic stress responses that accelerate atherosclerosis and cardiac dysfunction. This finding adds important nuance to cardiovascular risk assessment, suggesting that clinicians should consider patients' subjective financial anxiety alongside traditional risk factors. The mortality association was particularly pronounced among working-age adults under 65, highlighting vulnerability during peak earning years when financial pressures may be most acute. However, this preprint awaits peer review, and the observational design cannot establish causation between financial stress and heart disease. The results may reflect unmeasured confounders or reverse causation, where subclinical cardiovascular disease influences financial perception.